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In your view,Is access to healthcare a basic right? Should any basic healthcare services be provided to all US citizens?What about healthcare for US residents who are not citizens?Who should pay for basic healthcare services?Provide rationales for your responses.Topic 2Based on the IOM Report Assessing Progress on the Institute of Medicine Report The Future of Nursing:Examine the eight recommendations formulated to direct the future of nursing in Assessing Progress on the Institute of Medicine Report the Future of Nursing (pages 4–16) SEE ATTACHMENTSelect one recommendation and discuss its contribution to improving the health of the US population.APA format, add reference page
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Assessing Progress on the Institute of Medicine Report The
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Stuart H. Altman, Adrienne Stith Butler, and Lauren Shern, Editors;
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Copyright © National Academy of Sciences. All rights reserved.
Assessing Progress on the Institute of Medicine Report The Future of Nursing
Assessing Progress on the
Institute of Medicine Report
The Future of Nursing
Committee for Assessing Progress on Implementing the Recommendations of the
Institute of Medicine Report The Future of Nursing: Leading Change, Advancing
Health
Stuart H. Altman, Adrienne Stith Butler, Lauren Shern, Editors
Institute of Medicine
PREPUBLICATION COPY: UNCORRECTED PROOFS
Copyright © National Academy of Sciences. All rights reserved.
Assessing Progress on the Institute of Medicine Report The Future of Nursing
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
This study was supported by Contract/Grant No. 72309 from the Robert Wood Johnson Foundation.
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Suggested citation: National Academies of Sciences, Engineering and Medicine. 2015.
Assessing Progress on the Institute of Medicine Report The
Future of Nursing. Washington, DC: The National Academies Press.
PREPUBLICATION COPY: UNCORRECTED PROOFS
Copyright © National Academy of Sciences. All rights reserved.
Assessing Progress on the Institute of Medicine Report The Future of Nursing
The National Academy of Sciences was established in 1863 by an Act of Congress, signed by
President Lincoln, as a private, nongovernmental institution to advise the nation on issues
related to science and technology. Members are elected by their peers for outstanding
contributions to research. Dr. Ralph J. Cicerone is president.
The National Academy of Engineering was established in 1964 under the charter of the
National Academy of Sciences to bring the practices of engineering to advising the nation.
Members are elected by their peers for extraordinary contributions to engineering. Dr. C. D.
Mote, Jr., is president.
The National Academy of Medicine (formerly the Institute of Medicine) was established in
1970 under the charter of the National Academy of Sciences to advise the nation on medical
and health issues. Members are elected by their peers for distinguished contributions to
medicine and health. Dr. Victor J. Dzau is president.
The three Academies work together as the National Academies of Sciences, Engineering,
and Medicine to provide independent, objective analysis and advice to the nation and
conduct other activities to solve complex problems and inform public policy decisions. The
Academies also encourage education and research, recognize outstanding contributions to
knowledge, and increase public understanding in matters of science, engineering, and
medicine.
Learn more about the National Academies of Sciences, Engineering, and Medicine at
www.national-academies.org.
PREPUBLICATION COPY: UNCORRECTED PROOFS
Copyright © National Academy of Sciences. All rights reserved.
Assessing Progress on the Institute of Medicine Report The Future of Nursing
Copyright © National Academy of Sciences. All rights reserved.
Assessing Progress on the Institute of Medicine Report The Future of Nursing
COMMITTEE FOR ASSESSING PROGRESS ON IMPLEMENTING THE
RECOMMENDATIONS OF THE INSTITUTE OF MEDICINE REPORT
THE FUTURE OF NURSING: LEADING CHANGE, ADVANCING HEALTH
STUART H. ALTMAN (Chair), Sol C. Chaikin Professor of National Health Policy, Heller Graduate
School of Social Policy, Brandeis University, Weston, Massachusetts
CARMEN ALVAREZ, Assistant Professor, Department of Community-Public Health, Johns Hopkins
University School of Nursing, Baltimore, Maryland
CYNTHIA C. BARGINERE, Senior Vice President and Chief Operating Officer, Rush University
Hospital, Chicago, Illinois
RICHARD A. BERMAN, Interim Director, Patel College of Global Sustainability; Visiting Professor of
Social Entrepreneurship, Muma College of Business; Professor, Institute for Innovation &
Advanced Discovery, University of South Florida, Tampa
KAREN DONELAN, Senior Scientist in Health Policy, Mongan Institute for Health Policy,
Massachusetts General Hospital, and Associate Professor of Medicine, Harvard Medical School,
Boston
SUZANNE FFOLKES, Vice President of Communications, Research!America, Alexandria, Virginia
PAULA GUBRUD, Associate Professor, Oregon Health & Science University School of Nursing,
Portland
JACK NEEDLEMAN, Professor and Chair, Department of Health Policy and Management, Fielding
School of Public Health, University of California, Los Angeles
MICHELE J. ORZA, Senior Advisor to the Executive Director, Patient-Centered Outcomes Research
Institute, Washington, DC
ROBERT L. PHILLIPS, Vice President for Research and Policy, American Board of Family Medicine,
Washington, DC
EDWARD SALSBERG, Director, Health Workforce Studies, George Washington University Health
Workforce Institute and School of Nursing, Washington, DC
GEORGE E. THIBAULT, President, Josiah Macy Jr. Foundation, New York, NY
Study Staff
ADRIENNE STITH BUTLER, Senior Program Officer
LAUREN SHERN, Program Officer
THELMA COX, Administrative Assistant
Consultants
ERIN HAMMERS FORSTAG, Consultant Writer
RONA BRIERE, Consultant Editor
PREPUBLICATION COPY: UNCORRECTED PROOFS
v
Copyright © National Academy of Sciences. All rights reserved.
Assessing Progress on the Institute of Medicine Report The Future of Nursing
Copyright © National Academy of Sciences. All rights reserved.
Assessing Progress on the Institute of Medicine Report The Future of Nursing
REVIEWERS
This report has been reviewed in draft form by individuals chosen for their diverse perspectives and
technical expertise. The purpose of this independent review is to provide candid and critical comments
that will assist the institution in making its published report as sound as possible and to ensure that the
report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The
review comments and draft manuscript remain confidential to protect the integrity of the deliberative
process. We wish to thank the following individuals for their review of this report:
David Auerbach, Massachusetts Health Policy Commission
Elizabeth H. Bradley, Yale School of Public Health
Patrick H. DeLeon, Uniformed Services University of the Health Sciences
Catherine Dower, Kaiser Permanente
Kathleen Gallo, North Shore–Long Island Jewish Health System
Ann Hubbard, Indian River State College
Salimah H. Meghani, University of Pennsylvania School of Nursing
Wayne J. Riley, Vanderbilt University
John W. Rowe, Columbia University Mailman School of Public Health
William M. Sage, University of Texas at Austin
Richard Sorian, FleishmanHillard
Antonia M. Villarruel, University of Pennsylvania School of Nursing
Although the reviewers listed above have provided many constructive comments and suggestions,
they were not asked to endorse the conclusions or recommendations nor did they see the final draft of the
report before its release. The review of this report was overseen by Bobbie Berkowitz, Columbia
University School of Nursing and Columbia University Medical Center, and Mark R. Cullen, Stanford
University. They were responsible for making certain that an independent examination of this report was
carried out in accordance with institutional procedures and that all review comments were carefully
considered. Responsibility for the final content of this report rests entirely with the authoring committee
and the institution.
PREPUBLICATION COPY: UNCORRECTED PROOFS
vii
Copyright © National Academy of Sciences. All rights reserved.
Assessing Progress on the Institute of Medicine Report The Future of Nursing
Copyright © National Academy of Sciences. All rights reserved.
Assessing Progress on the Institute of Medicine Report The Future of Nursing
Preface
In 2010, the Institute of Medicine (IOM) released a landmark report titled The Future of Nursing:
Leading Change, Advancing Health. In the preface to the report, the chair and vice chair of the
committee, Donna Shalala and Linda Burnes Bolton, stated that the passage of the Patient Protection and
Affordable Care Act, also in 2010, would require that the U.S. health care system expand to accommodate
a significant increase in demand for services, particularly those needed to manage patients with chronic
conditions or mental health illnesses or for basic primary care. They noted that nurses were in a unique
position to take on a leadership role in helping the nation attain these goals. They stated that “nurses have
a key role to play as team members and leaders for a reformed and better integrated patient-centered
health care system.”
The Future of Nursing was sponsored by the Robert Wood Johnson Foundation (RWJF), and
senior staff of RWJF helped the IOM gather material for the 2-year study. Following the publication of
the report, RWJF supported the creation of the Future of Nursing: Campaign for Action (the Campaign)
and its 51 state Action Coalitions. The efforts of outside groups devoted to the implementation of the
IOM report’s recommendations have been extraordinary.
It has now been 5 years since The Future of Nursing report was issued, and RWJF asked the IOM
to assess the progress made toward implementing the report’s recommendations and to identify areas that
should be emphasized over the next 5 years to help the Campaign fulfill the recommendations. The
committee convened to carry out this study was not asked to reexamine the merits of or amend the
recommendations of The Future of Nursing report. I was delighted when the new president of the now
National Academy of Medicine, Dr. Victor Dzau, asked me to chair the committee and take on this task.
The field of nursing has been of special interest to me since I published my first book—Present and
Future Supply of Registered Nurses—in the early 1970s. After reviewing The Future of Nursing report
and analyzing the information collected as part of the present study, it is clear to me that the nursing
profession is a far more important component of the U.S. health care system than it was 45 years ago.
The committee conducted three public workshops and met as a group four times. In addition, it
held three full-committee and several smaller subcommittee phone meetings. I am especially appreciative
of the time commitment and pursuit of excellence of the 11 other members of our committee. Without
their expertise, their experience, and their knowledge of the information that could be used to assess the
changes that have occurred in the health care system, this report could not have been completed. We also
are indebted to the staff of RWJF for their help in assembling this information. We appreciate as well the
efforts of the three IOM staff members and the consultant writer who guided us through the study and the
writing of this report. In particular, the dedication and drive of our study director, Adrienne Stith Butler,
was irreplaceable.
Clearly much has been accomplished by the Campaign and other stakeholders, and it is readily
apparent that The Future of Nursing report was a catalyst for a number of new activities and accelerated
several trends that had begun before the report was completed. The present report is timely in that it
allows for reflection on the progress that has been achieved over the last 5 years in implementing the
recommendations of The Future of Nursing report, while leaving time for the Campaign and others to
adjust to the many changes occurring in nursing and the health care system. The committee worked
PREPUBLICATION COPY: UNCORRECTED PROOFS
ix
Copyright © National Academy of Sciences. All rights reserved.
Assessing Progress on the Institute of Medicine Report The Future of Nursing
diligently over a short period of time to assemble and review the available data and evidence to help in
understanding the changes that have occurred in the field of nursing—the structure of its education
system, who is entering the field and in which programs, where nurses are employed, the attitudes of
others about the appropriate role of nurses, and where possible how the expanded use of nurses has
impacted the quality of patient care. With the help of this assessment, the committee generated a number
of recommendations, which we hope will assist the Campaign, its state Action Coalitions, and other
groups and stakeholders in positively impacting the field of nursing and improving the U.S. health care
system.
Stuart H. Altman, Chair
Committee for Assessing Progress on Implementing the Recommendations of the Institute of Medicine
Report The Future Of Nursing: Leading Change, Advancing Health
PREPUBLICATION COPY: UNCORRECTED PROOFS
x
Copyright © National Academy of Sciences. All rights reserved.
Assessing Progress on the Institute of Medicine Report The Future of Nursing
Acknowledgments
Many individuals and organizations made important contributions to the study committee’s
process and to this report. The committee wishes to thank these individuals, but recognizes that attempts
to identify all and acknowledge their contributions would require more space than is available in this brief
section.
To begin, the committee would like to thank the sponsor of this study; funds for the committee’s
work were provided by the Robert Wood Johnson Foundation. The committee also gratefully
acknowledges the contributions of the many individuals and organizations that assisted in the conduct of
the study. Their perspectives were valuable in understanding the work undertaken to implement the
recommendations from the 2010 Institute of Medicine report The Future of Nursing: Leading Change,
Advancing Health. The committee thanks those individuals who provided important presentations and
oral testimony at its open workshops. Appendix A lists these individuals and their affiliations. Written
testimony received from nearly 100 individuals and organizations also helped the committee understand
the status of implementation of the recommendations. The committee is grateful for the time, effort, and
valuable information provided by all of these dedicated individuals and organizations. We are immensely
grateful for the organizations that provided the committee with data and other inputs: the Accreditation
Commission for Education in Nursing (ACEN), American Association of Colleges of Nursing (AACN),
Commission on Collegiate Nursing Education (CCNE), the National League for Nursing (NLN), the
Center to Champion Nursing in America and Robert Wood Johnson Foundation, and TCC Group.
Finally, many within the National Academies of Sciences, Engineering, and Medicine were
helpful to the study staff. We would like to thank Clyde Behney, Laura DeStefano, Chelsea Frakes, Greta
Gorman, Nicole Joy, Ellen Kimmel, Fariha Mahmud, Rebecca Morgan, Jennifer Walsh, and Colleen
Willis for their invaluable assistance.
PREPUBLICATION COPY: UNCORRECTED PROOFS
xi
Copyright © National Academy of Sciences. All rights reserved.
Assessing Progress on the Institute of Medicine Report The Future of Nursing
Copyright © National Academy of Sciences. All rights reserved.
Assessing Progress on the Institute of Medicine Report The Future of Nursing
Contents
SUMMARY
S-1
1
INTRODUCTION
Context
Study Scope
Overview of The Future of Nursing: Leading Change, Advancing Health
The Future of Nursing: Campaign for Action
RWJF Activities Outside of the Campaign
Organization of the Report
References
1-1
1-1
1-3
1-5
1-7
1-15
1-17
1-17
2
REMOVING BARRRIERS TO PRACTICE AND CARE
Activity and Progress
Discussion
Findings and Conclusions
Recommendation
References
2-1
2-3
2-5
2-10
2-11
2-11
3
ACHIEVING HIGHER LEVELS OF EDUCATION
Increase the Proportion of Nurses with a Baccalaureate Degree to 80 Percent
by 2020
Implement Nurse Residency Programs
Double the Number of Nurses with a Doctorate by 2020
Ensure that Nurses Engage in Lifelong Learning
Recommendations
References
3-15
3-23
3-30
3-34
3-36
PROMOTING DIVERSITY
Introduction
Activity
Progress
Discussion
Findings and Conclusions
Recommendation
References
4-1
4-1
4-3
4-6
4-15
4-17
4-18
4-19
4
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xiii
Copyright © National Academy of Sciences. All rights reserved.
3-1
3-1
Assessing Progress on the Institute of Medicine Report The Future of Nursing
xiv
5
6
CONTENTS
COLLABORATING AND LEADING IN CARE DELIVERY AND
REDESIGN
Interprofessional Collaboration
Preparing Nurses to Lead
Nurses in Leadership Positions
The Campaign for Action’s Communication Efforts to Support Collaboration
and Leadership
Recommendations
References
IMPROVING WORKFORCE DATA INFRASTRUCTURE
Activity and Progress
Discussion
Findings and Conclusions
Recommendation
References
5-1
5-1
5-9
5-12
5-14
5-18
5-19
6-1
6-1
6-5
6-9
6-10
6-11
APPENDIXES
A
B
C
Data Sources and Methods
Recommendations of the Institute of Medicine Reports The Future of Nursing:
Leading Change, Advancing Health
Committee Biographies
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A-1
B-1
C-1
Assessing Progress on the Institute of Medicine Report The Future of Nursing
Acronyms
AACN
AAMC
AAN
AANP
ACA
ACCME
ACEN
ACP
ACPE
ACS
ADN
AMA
ANA
ANCC
AONE
APIN
APRN
American Association of Colleges of Nursing
Association of American Medical Colleges
American Academy of Nursing
American Association of Nurse Practitioners
Patient Protection and Affordable Care Act
Accreditation Council for Continuing Medical Education
Accreditation Commission for Education in Nursing
American College of Physicians
Accreditation Council for Pharmacy Education
American Community Survey
associate’s degree in nursing
American Medical Association
American Nurses Association
American Nurses Credentialing Center
American Organization of Nurse Executives
Academic Progression in Nursing
advanced practice registered nurse
BSN
bachelor’s of science in nursing
Campaign
CCNA
CCNE
CDC
CHC
CMA
CMMI
CMS
CNO
CPS
Future of Nursing: Campaign for Action
Center to Champion Nursing in America
Commission on Collegiate Nursing Education
Centers for Disease Control and Prevention
Community Health Center, Inc.
California Medical Association
Center for Medicare and Medicaid Innovation
Centers for Medicaid & Medicare Service …
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